Surgical nursing
The suction tip best used to remove large volumes of fluid is the a) Yankauer b) adson c) poole d) plastic connector
C) poole
T/F the Balfour retractor is a self-retaining retractor that is frequently used during abdominal exploratory procedures a)true b)flase
True
What information is included in the patients signalment? a) Age, gender, breed b) proceed with caution signals c) previous surgical history d) AOTA
a) age, gender, breed
Which of the following postoperative complications involve(s) premature suture loss and surgical site opening? a Dehiscence. b Hemorrhage. c Seroma. d Hematoma. e Both c and d.
a) dehiscence
Ringed instruments should be held with the rings a) distal to the first knuckly of both the thumb and ring finger b) proximal to the first knuckle of both the thumb and ring finger c) distal to the first knuckle of the thumb, but proximal to the first knuckle of the ring finger d) proximal to the first knuckle of the thumb, but distal to the first knuckle of the ring finger
a) distal to the first knuckle of both the thumb and ring finger
Which scissors if finer and more lightweight and therefore used on delicate tissues a) Metzenbaum b) mayo c) operating d) suture
a) metzenbaum
Which reflex significantly diminishes or is absent when the patient enters the surgical plane of anesthesia? a. Palpebral. b. Laryngeal. c. Pedal. d. Corneal.
a) palpebral
Débridement is: a The process of removing dead tissue and debris from a wound. b The name given to a divorce caused by a household of too many dogs. c A way to check for a fluid wave in the abdomen of animals with suspected ascites or hemoabdomen. d Necessary in all cases of neoplastic surgery. e NOTA.
a) the process of removing dead tissue and debris from a wound
When might a situation of negative pressure exist in the anesthesia system? a) when the oxygen source id depleted b) during anesthesia induction c) during recovery from anesthesia d) only during "high flow" anesthesia
a) when the oxygen source is depleted
Which of the following is the correct order of events associated with performing the surgical hand prep and donning the surgical gown and gloves? a Confirm removal of or remove all jewelry → open gown and glove packs → don cap and mask → perform hand prep → dry hands using sterile hand towel → gown → perform closed gloving. b Perform hand prep → open gown and glove packs → don cap and mask → don gown and perform open gloving. c Perform hand prep → open gown and glove packs →don cap and mask → don gown and gloves. d d. Remove all jewelry → gown and glove → perform hand prep. e NOTA
a)Confirm removal of or remove all jewelry → open gown and glove packs → don cap and mask → perform hand prep → dry hands using sterile hand towel → gown → perform closed gloving.
Of the following needle holders, which have scissors included in the jaws? a) olsen-hegar b) mayo-hegar c)derf d) Crile-wood
a)olsen-hegar
A 27kg patient would need what size rebreathing bag? a) 3L b) 2l c) 1L d) 0.5L
b) 2L
To ensure the most accurate blood pressure reading, the cuff should be what percentage of the width of the limb? a 25% b 40% c 60% d 75%
b) 40%
Ideally the surgery room is a) at least 12 x12 feet in dimension b) a separate room used only for surgery c) adjacent to the scrub sinks d) has no doors for easy communication
b) a separate room used only for surgery
When the rebreathing bag I being squeezed to ventilate the patients manually, the pop-off valve needs to be a) opena nd then closed after giving a breath b) closed and then opened after giving a breath c) open and remain closed after giving a breath d) closed and remain closed after giving a breath
b) closed and then opened after giving a breath
Topical antimicrobial medications are usually: a Not used on wounds. b Discontinued once granulation tissue appears in the wound. c Only used once granulation tissue appears in a wound. d Only applied to anesthetized patients with wounds. e NOTA.
b) discontinued once granulation tissue appears in the wound
What position is the patient placed in for abdominal exploratory surgery? a) sternal recumbency b) dorsal recumbency c) right or left lateral recumbency, depending on which side of the abdomen needs to be accessed
b) dorsal recumbency
How frequently should physiologic parameters be recorded in the anesthesia log during a surgery? a. Every minute. b. Every 5 minutes. c. Every 15 minutes. d. Whenever the technician has the time.
b) every 5 minutes
What areas of the scrubbed-in personnel's gown are part of the sterile field? a Back of the gown. b Front from chest to the level of the sterile field. c Cuffs of the sleeves. d All of the above if the gown was autoclaved. e NOTA
b) front from chest to the level of the sterile field
What should the surgical nurse don on leaving the surgery suite? a Street clothes. b Laboratory coat. c Shoe covers. d Cap and mask. e NOTA
b) laboratory coat
When does the postoperative recovery period begin for the surgical patient? a As soon as the surgeon begins closing the incision. b On discontinuation of anesthesia. c On regaining full mental capacity. d On return of normal vital signs (temperature, pulse, respiration) and consciousness. e NOTA.
b) on discontinuation of anesthesia
Which of the following surgical procedures may create challenges for monitoring the patient because of patient positioning? a Total hip replacement. b Perineal urethrostomy. c Prostate biopsy. d Lateral ear ablation.
b) perineal urethrostomy
Which of the following is false regarding the surgical hand preparation? a The preparation should begin with a quick, general hand and arm wash. b The purpose of the prep is to sterilize the skin on the surgeon's hands and arms. c Stiff scrub brushes should not be used to scrub the hands and arms. d The product manufacturer determines the recommended length of time the product should be scrubbed on the hands and arms during the surgical hand prep.
b) the purpose of the prep is to sterilize the skin on the surgeon's hands and arms
The first ground drape placed for four corner draping is on which side of the patient? a) the cranial side b) the side closest to person draping c) the side closest to the assistant d) the caudal side
b) the side closest to the person draping
Which of the following statements is false regarding the sterile field? a Unscrubbed personnel should not walk between two sterile fields. b Unscrubbed personnel should never face the sterile field. c All unscrubbed personnel should keep a safe distance from the sterile field. d Only sterile items should be in the sterile field. e The sterile field should never be left unattended.
b) unscrubbed personnelshould never face the sterile field
Why is it important to confirm that the pop-off valve is completely open after the anesthesia machine and circuit are checked for leaks? a) it can only reset if it is open b) when the patient is connected to the anesthesia machine with the pop off valve is closed, the patient will not be able to exhale c) it is not important, the pop off valve can be open or closed after the system is checked for leaks d) AOTA
b) when the patients is connected to the anesthesia machine with the pop off valve closed, the patient will not be able to exhale
Why should taking the patients temp be saved for the end of the PE? a) it is the least important part of the PE b)Most animals dislike having their temperatures taken rectally, and it is easier to perform a PE on a cooperative patient; taking the temperature early during the PE may make the patient uncooperative for the rest of the examination. c) by the end of the PE, the examiner should have already ascertained whether the patient is febril, and only then does the temperature need to be taken d) NOTA e)AOTA
b)Most animals dislike having their temperatures taken rectally, and it is easier to perform a PE on a cooperative patient; taking the temperature early during the PE may make the patient uncooperative for the rest of the examination.
Which of the following scalpel blade grips allows for a finer, more precise incision? a) fingertip b) pencil c) palmed d) slide
b)pencil
How long should an animal be allowed to not eat before intervention is sought? a 1 day. b 2 days. c 3 days. d 4 days. e 5 days
c) 3 days
Which instrument would be used to collect large amounts of bone graft material intraoperatively? A) Jacobs hand chuck b) Periosteal elevator c) bone curette d) biopsy needle
c) bone curette
Hypotension can be caused by: a Increased heart rate. b Vasoconstrictive drugs. c Cardiac insufficiency. d Patient obesity
c) cardia insufficiency
What phrase is used to describe the excitement and exaggerated and uncontrollable movements some patients exhibit during the recovery phase of anesthesia? a Drug-induced dysphoria. b Endorphin euphoria. c Emergence delirium. d Reverse induction. e NOTA
c) emergence delirium
Which tactic may stop a cat from purring during thoracic auscultation? a) gently squeezing the thorax with one hand while the other hand holds the stethoscope on the chest wall b) massaging under the cats chin c) holding the cat near a sink or faucet, with or without the water running d) AOTA e)NOTA
c) holding the cat near a sink or faucet, with or without the water running
The terms effleurage and pétrissage refer to which physical therapy modality? a Cryotherapy. b Passive range-of-motion exercises. c Massage. d AOTA. e NOTA.
c) massage
All of the following are goals of balanced anesthesia except which? a) maxiumize the positive effects of certain drugs b) minimize the side effects of certain drugs c)Maximize the likelihood of allergic reactions d) minimize cardiac depression
c) maximize the likelihood of allergic reactions
Which valve allows for room air to enter the anesthesia system if negative pressure is detected in the system? a) pop off valve b) flowmeter c) negative pressure relief valve d) pressure manometer
c) negative pressure relief valve
A surgical consent form includes which of the following a) all of the patients prior surgeries, medical history and current medications b) an estimates for the surgical procedures to be prefomed c) ID of patient, the specific procedures to be preformed along with the potential risk to the patient, and the physicians who will preform the procedures and the signature of the owner consenting to the procedures d) the patients current diet
c)ID of patient, the specific procedures to be preformed along with the potential risk to the patient, and the physicians who will preform the procedures and the signature of the owner consenting to the procedures
Why are leading questions inappropriate to ask during the history taking? a) they make the owner feel compelled to answer a certain way b) they may encourage the owner to answer inaccuratly c) they are appropriate and should be asked d) A and B e) NOTA
d) A and B
How can a veterinary technician determine whether a patient's pain was successfully managed through surgery and into the postoperative phase? a Recovery from anesthesia is smooth. b The patient is calm and quiet postoperatively. c Signs of overt pain (e.g., vocalization, excessive movement) are absent. d AOTA. e Both a and c
d) AOTA
What can be done to help prevent a deep-chested dog from tilting to the side while in dorsal recumbency? a) using a v-tray b) bracing the chest with sandbags c) trying the forelegs crossed over the chest d) AOTA e) A and C
d) AOTA
What does managing the instrument table involve? a Keeping the instruments organized for quick retrieval. b Counting instruments and gauze squares at the beginning and end of the procedure. c Loading the needle holders with suture needle. d AOTA e Only A & C
d) AOTA
What is the purpose of premedicating a patient before inducing anesthesia for surgery? a) to provide a smooth transition to anesthesia b) to provide a preemptive analgesia c) to facilitate a smooth recovery from anesthesia d) AOTA e)NOTA
d) AOTA
What needs to be done to the patient after the hair clip and before the patient is moved into the surgery suite? a Vacuum the clipped hair and clipped area of skin. b Check to see whether the bladder needs expressing. c Perform initial skin scrub. d AOTA e NOTA
d) AOTA
What should the surgical nurse don on leaving the surgery suite? a Street clothes. b Laboratory coat. c Shoe covers. d Cap and mask. e NOTA
d) AOTA
Which of the following conditions can contribute to a prolonged recovery from anesthesia? a Hypoglycemia. b Liver disease. c Kidney disease. d AOTA e Both b and c
d) AOTA
Which of the following contributes to hypothermia in the anesthetized patient? a Anesthetic-induced muscle relaxation. b The surgical prep using water and alcohol. c Administering room-temperature intravenous fluids. d AOTA
d) AOTA
Which of the following statements is true? a Bandages, splints, and casts are used to immobilize bones and joints. b Immobilization helps decrease pain associated with fractures. c Immobilization facilitates healing by securing bone fragments close together. d AOTA.
d) AOTA
Why is it important to use surgical instruments only for their designed purpose? a) to avoid damaging them b) to protect their useful life c) the high-quality instruments are expsensive and should be handled with care d) AOTA
d) AOTA
Which of the following should be performed on the day of the surgery? a) through physical exam b) review of the patients medical history with the owner c) verbal review of the consent form and obtaining the owner's signed consent for anesthesia and surgery d) AOTA e)NOTA
d) ATOA
Why is it important to review all medications and supplements that a patient is taking before beginning the surgery a) to avoid possible drug interactions b) to know whether other diagnostic tests are indicated c) to make any necessary adjustments to the anesthetic protocol d) AOTA
d) ATOA
What position is the patient placed in on the surgery table for thoracic surgery? a) dorsal recumbency b) right lateral recumbency c) left lateral recumbency d) any of the above may be appropriate e) NOTA
d) any of the above may be appropriate
What are the two most important practices used to prevent surgical infections? a Aseptic and septic technique. b Sterile and septic technique. c Septic and antiseptic technique. d Aseptic and sterile technique. e Sterile and antiseptic technique
d) aseptic and sterile technique
Why is it important for ratchets to remain locked when the jaw is closed? a) the instrument needs to be reliable mechanism of holding the target tissue or item b) if the ratchets do not remain locked, complications could result c) ratches need to be protected by lock and key so that o nly the surgeon can unlock them when it is appropriate
d) both A and B
Why should the patient's identity be verified before the animal is anesthetized for surgery? a To avoid anesthetizing the wrong patient. b To avoid performing surgery on the wrong patient. c It is not necessary to cross-check the patient's correct identity because any good technician should be able to distinguish all black cats in the hospital on any given day on the basis of physical appearance alone. d Both a and b. e NOTA
d) both A and B
With a bandaged limb, leaving the toes exposed: a Is useful to monitor the amount of swelling that may occur under the bandage. b Is an example of a poorly placed bandage. c Allows the animal's caregiver to compare the toes on the bandaged limb with the toes on the other limb. d Both a and c. e NOTA.
d) both a and c
Which monitoring device measures exhaled CO2 levels? a Pulse Oximeter b Electrocardiograph c Sphygmomanometer d Capnometer
d) capnometer
Of the procedures listed below, which should be scheduled as the first of the day? a) corneal laceration b) splenectomy c) OHE d) Knee replacement
d) knee replacement
Which part of the anesthesia machine indicates the amount of pressure in the system? a) pressure-reducing valve b) flowmeter c) carbon dioxide canister d) pressure manometer
d) pressure manometer
Which of the following is the next step after the patient has been induced with anesthesia and the intended surgical site has been clipped and had initial prep performed? a)The patient is moved to the surgery room, positioned on and secured to the table, then draped, and the surgeon begins surgery by making an incision. b )The final prep is applied, and the patient is moved to the surgery room and positioned on and secured to the table. c )The patient is moved to the surgery room, the final prep is performed, and the patient is positioned on and secured to the table. d )The patient is moved to the surgery room and is positioned on and secured to the surgery table, and the final prep is performed. e )NOTA
d) the patient is moved to the surgery room and is positioned on and secured to the surgery table, and the final prep is performed
What part of the anesthesia machine converts the liquid anesthetic into a gas anesthetic? a) pressure manometer b) oxygen Flowmeter c) Pressure reducing Valve d) vaporizer
d)vaporizer
What are some safe techniques for preventing hypothermia in small animal surgical patients? a Circulating warm-water pads. b Electric heating pads. c SnuggleSafe discs. d AOTA e A and C
e) A and C
Massage provides which of the following benefits to the surgery patient? a Muscle relaxation. b Improved blood and lymph flow. c Pain relief. d Both a and b. e AOTA.
e) AOTA
Which of the following methods can hasten a patient's recovery from anesthesia? a Physical stimulation. b Oxygen supplementation with or without manual ventilation. c Warming measures. d Reversal agents. e AOTA
e) AOTA
Which of the following statements regarding urinary catheters is/are true? a Catheters help ensure urethral patency. b Catheters allow measurement of urine production, which reflects the condition of the kidneys. c Urinary catheters help keep the patient clean and dry. d Both a and c. e AOTA
e) AOTA
Which of the following should be assessed during the history taking? a) patients attitude and mental status b) pateints previous medical problems and treatments c) pateints ability to see and hear d) patients gait and body condition e) AOTA
e) ATOA
For which of the following is the surgical assistant responsible? a Monitoring the patient. b Maintaining sterility. c Maintaining hemostasis. d AOTA e B & C
e) B and C
Which of the following is true regarding positioning patients on the surgery table? a) the particular position of the limbs is insignificant because the patient is anesthetized and cannot feel any pain that might be associated with awkward positioning b) bony prominences should be cushioned to protect against excessive compression c) the patients legs should not be forced into unnatural anatomic alignment d) AOTA e) B and C
e) B and C
Which of the following statements is true regarding the sterile field? a Only scrubbed-in personnel need to know what is sterile and nonsterile. b Only the circulating nurse needs to keep track of what is sterile and nonsterile. c Excessive talking and movement among scrubbed-in personnel are acceptable, but not among non-scrubbed-in personnel. d AOTA e NOTA
e) NOTA
Why does an orthopedic "clip and prep" of an extremity need to include a circumferential clip around the entire limb? a If the incision goes all the way through the limb and out the other side, the other side will already be prepared for this scenario. b If the surgeon mistakenly incises the wrong side of the limb with the first incision, and if the leg is clipped circumferentially, the mistake is easily corrected. c For patient comfort. d AOTA e NOTA
e) NOTA
Which of the following contributes to hypothermia in the anesthetized patient? a Anesthetic-induced muscle relaxation. b The surgical prep using water and alcohol. c Administering room-temperature IV fluids. d Breathing cold gases from compressed cylinders. e All of the above.
e) all of the above
Which of the following statements regarding drains is/are true? a Drains are usually removed 3 to 5 days after surgery. b Petrolatum-based ointments applied to the skin around the drain's exit site help prevent exudates from accumulating and clogging the drain's exit site. c All types of drains have hollow lumens to allow for the fluid to drain out of the wound through them. d AOTA. e Both a and b.
e) both a and b
Central venous pressure measurements require that a central line be placed. a True b False
false
Once the patient is extubated, the anesthetist can relax because all risks associated with anesthesia immediately cease on extubation
false
T/F Anesthesia provides multimodal analgesia
false
T/F Chlorhexidine scrub or solution can be used as the final, sterile surgical paint
false
T/F Jewelry and long fingernails are protected by the sterile gloves worn by the sterile gloves worn by scrubbed-in surgical personnel and therefore do not need to be removed or cut
false
T/F brachycephalic breeds should have the endotracheal tube removed at the first sign of return of the ability to swallow
false
T/F for orthopedic surgeries of the extremity, only the side of the limb to be incised needs to be clipped and prepped
false
T/F it is acceptable practice for the circulating nurse to reach over the sterile field if required to assist the surgeon or surgical assistant
false
T/F it is recommended that all nonscrubbed personnel wear long-sleeved laboratory coats in the surgery room
false
T/F rubbing or wiping a "bleeder" with a gauze square is the best means of maintain hemostasis
false
T/F stroke-through renders surgical drapes "sterile proof", and therefore drapes affected by strike-through cannot become contaminate under any cirumstance
false
T/F the best drape material is 200 thread count linen
false
T/F when scrubbing the skin of the intended surgical site, sufficient friction should be generated to cause hyperemia
false
True or False: Going into surgery with an empty stomach is the best way for the surgical nurse to avoid experiencing nausea and hypoglycemia if the procedure is unexpectedly long. a True b False
false
The first spray of the final prep should be directly over the incision site. a True b False
false Explanation: The first spray should be directed at the kick bucket to remove any debris or bacteria from the nozzle
What does it mean when a drape is fenestrated?
that there is a hole or an opening in the drape that will be place over the proposed incision site
Why should scrub tops be short sleeved?
to allow scrubbing of above the elbows
Why is it important to know the approximate volume of blood a sponge can absorb
to estimate the amount of blood volume the patient lost intraoperatively
T/F all animals that undergo an anesthetic/surgical procedure are at risk for hypothermia
true
T/F cold generally is applied to recent wounds and heat to wounds at least 3 to 5 days old
true
T/F penetrating towel clamps are used to secure drapes to the patients
true
T/F peripheral catheters generally suffice for short ter use and central lines are appropriate for long-term vascular access
true
T/F physical therapy should be performed shortly after analgesics have been administered to the surgical patient
true
T/F the edges of all sterile packages are considered nonsterile
true
T/F the surgical nurse scrub top should be tucked into the scrub pants
true
T/F when passing ring-handled instruments to the surgeon, the assistant should firmly place the rings into the surgeons palm
true
True or False: Going into surgery with an empty stomach is the best way for the surgical nurse to avoid experiencing nausea and hypoglycemia if the procedure is unexpectedly long. a True b False
true
True or False: If unscrubbed personnel enter or touch the sterile field, it is no longer considered sterile. a True b False
true
t/F it is accepted practice to scrub a patient initially with a providone-iodine product
true